Akademik Veri Yönetim Sistemi
EANS2024, Sofija, Bulgaristan, 13 - 17 Ekim 2024, cilt.4, ss.92, (Özet Bildiri)
Background: In microprolactinoma patients, the classically recommended primary treatment method is medical therapy. Surgical treatment is considered as secondary treatment in the presence of drug resistance and intolerance following the use of dopamine agonists, or when patients prefer surgery over medical treatment. The high rates of hormonal remission and low complication rates after surgery for microprolactinomas suggest that the surgical outcomes of endoscopic surgeries may be similar to or better than medical therapy in well-selected patients. Methods: This study is a retrospective cohort analysis of microprolactinoma patients operated with the endoscopic transnasal approach by a single experienced pituitary surgeon at a tertiary center between August 1997 and January 2024, with the 20addedcases after the article(1) of 105 cases that was published in 2023. The inclusion criteria of the study were increased prolactin levels, presence of a microadenoma (<10 mm in diameter) on pituitary magnetic resonance imaging (MRI), and histopathologically confirmed diagnosis of lactotroph adenoma. Results: This study includes 125 cases (107 females, 18 males). The postoperative day 1 remission rate is 86.4%, while the long-term remission rate is 76.8%. The long-term remission rates of patients in the preference group were 90%, drug-resistant group were 63.7% and intolerant group were 82.3%. The remission rates in patients using dopamine agonists for more than 3 years was 28.1%andthose using for a shorter duration was 50%. The surgical complication rate is 4%. Conclusions: According to our findings, endoscopic transnasal surgery performed by an experienced neurosurgeon in well-selected microprolactinoma patients has similar cure rates to medical treatment and may be an alternative primary treatment option to dopamine agonists.